Yes, You Can Now Use Your HSA for Direct Primary Care

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A federal law signed in July 2025, often called the One Big Beautiful Bill Act, updated the rules for health savings accounts and direct primary care, and the IRS has since issued guidance on it. The short version: for a lot of people in Chandler and the East Valley, a DPC membership and an HSA can now work together. Here's what changed, who it applies to, and what to double-check before you plan around it.

What Changed for HSAs and Direct Primary Care in 2026

Before this year, being in a direct primary care arrangement could keep you from contributing to an HSA, even if your health plan was HSA-eligible.

Starting January 1, 2026, two things are different:

• Being in a qualifying direct primary care arrangement no longer disqualifies you from contributing to your HSA.
• You can use HSA money to pay qualifying DPC membership fees tax-free.

There are limits and conditions, which we'll get to.

Who Qualifies to Use an HSA With Direct Primary Care

The first piece is your health plan. To contribute to an HSA at all, you need to be enrolled in an HSA-eligible plan. For 2026, that includes a few paths people don't always realize they have:

• Employer high-deductible plans that were already HSA-qualified, which now work alongside a DPC membership too.
• Bronze plans bought through the Marketplace at HealthCare.gov, which count as HSA-eligible starting in 2026.
• Catastrophic Marketplace plans, which also count starting in 2026. Right now these are limited to people under 30 or people who qualify for a hardship or affordability exemption. That may change, so check HealthCare.gov for the current rules.

The second piece is the membership itself. To qualify, it has to be primary care from primary care practitioners, paid for with a fixed periodic fee, like a monthly membership. That's how our membership at Lunara is set up: a flat monthly fee for primary care with our nurse practitioner, not per-visit billing.

The 2026 Limits, and How Lunara's Prices Fit

The law also caps how much a membership can cost and still qualify. For 2026, the limits are:

• Up to $150 a month for a membership covering one person
• Up to $300 a month for a membership covering more than one person

These amounts are set to adjust for inflation in later years, so think of them as the 2026 numbers. Here's how our current membership pricing lines up:

• Individual, $99 a month: under the $150 limit
• Couple, $180 a month: under the $300 limit
• Family of 3, $249 a month: under the $300 limit
• Family of 4, $299 a month: under the $300 limit

Each additional family member adds $25 a month, so a family of five or more ($324 a month and up) goes past the $300 limit. If that's your household, ask your HSA administrator or a tax professional how that works for you before you count on paying the whole fee from your HSA.

How Paying With Your HSA Works

There are two common ways to handle it:

1. Pay with your HSA card. Many HSA accounts come with a debit card you can use for your membership fee.
2. Pay another way, then reimburse yourself. You pay the fee from your regular account and submit a receipt to your HSA to pay yourself back. We can provide itemized receipts for HSA reimbursement.

Either way, keep your receipts in case your HSA administrator asks for documentation. HSA money also rolls over year to year and stays with you, even if you change jobs or plans. You can contribute up to the annual IRS limit.

What to Confirm Before You Count On It

We're a primary care clinic, not tax advisors, so think of this as a helpful starting point rather than tax advice. A few quick questions for your HSA administrator or a tax professional can make sure everything lines up for you:

• Is my health plan HSA-eligible for the year I'm enrolling in?
• Does my DPC membership count as a qualifying arrangement for my account?
• If my family's membership is over $300 a month, how should I handle the difference?

DPC Isn't Insurance, and That Still Matters

This part didn't change with the new law. Direct primary care is not insurance. It covers your everyday primary care, but you still want a health plan for the big stuff: emergencies, hospital stays, surgery, specialists, advanced imaging, and most prescriptions. The HSA-eligible plan and the membership are two different layers, and they work best together.

For a closer look at what membership includes day to day, see our post on what direct primary care actually includes.

Where This Fits in Open Enrollment

Open enrollment is when all of this becomes practical. For Marketplace plans in Arizona, open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027. Enroll by December 15 if you want coverage to start January 1. Employer open enrollment timing varies, and it's often in the fall.

As you compare plans, it may help to ask two questions side by side: is this plan HSA-eligible, and how will I handle everyday care? For some people, pairing an HSA-eligible plan with a DPC membership could make the year more predictable. For others, a plan with richer everyday coverage makes more sense. It depends on your plan, your health, and your household.

A Simple Takeaway

Starting in 2026, an HSA and a direct primary care membership can work together, as long as your plan is HSA-eligible and the membership stays within the limits. Our individual, couple, and family memberships up to four people fit under the 2026 caps. A quick check with your HSA administrator is a smart next step before open enrollment.

Common Questions

Can I use my HSA to pay for a direct primary care membership?

Starting January 1, 2026, yes, for many people. HSA money can pay qualifying direct primary care membership fees tax-free, up to $150 a month for one person or $300 a month for more than one person in 2026. Confirm the details for your own account with your HSA administrator or a tax professional.

Which health plans are HSA-eligible for 2026?

Employer high-deductible plans that were already HSA-qualified still count, and starting in 2026, Bronze and Catastrophic plans bought through HealthCare.gov count too. Catastrophic plans are currently limited to people under 30 or people with a hardship or affordability exemption. Check your plan's details to confirm.

Does Lunara provide receipts for HSA reimbursement?

Yes. If you pay your membership another way and want to reimburse yourself from your HSA, we can provide itemized receipts. Keep them in case your HSA administrator asks for documentation.